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Chronically anticoagulated patients who need surgery: Can low‐molecular‐weight heparins really be used to “bridge” patients instead of intravenous unfractionated heparin?
Author(s) -
Jaff Michael R.
Publication year - 2009
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.22000
Subject(s) - medicine , warfarin , heparin , bridging (networking) , low molecular weight heparin , venous thromboembolism , intensive care medicine , anticoagulant , surgery , anesthesia , thrombosis , cardiology , computer network , computer science , atrial fibrillation
Patients at high risk of arterial or venous thromboembolic events often receive chronic treatment with long‐term oral anticoagulants such as warfarin. However, if these patients require an invasive procedure, they may require a temporary interruption of their warfarin therapy to minimize their bleeding risk during the procedure. As warfarin has a long half‐life and an unpredictable pharmacokinetic profile, short‐acting parenteral anticoagulants, such as unfractionated heparin (UFH) and low‐molecular‐weight heparin (LMWH), may be of benefit in protecting the patient from thromboemboli while their warfarin dose is withheld. Such “bridging therapy” has traditionally been provided in‐hospital with intravenous UFH; however, recent data have suggested that LMWH may be an effective alternative, with potential cost‐savings due to the ability to provide bridging therapy in the outpatient setting. © 2009 Wiley‐Liss, Inc.